Provider Demographics
NPI:1669580932
Name:PULMONARY DISEASE CLINIC SLEEP COMPANY, LLC
Entity type:Organization
Organization Name:PULMONARY DISEASE CLINIC SLEEP COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:VIATOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:225-766-1163
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-766-1163
Mailing Address - Fax:
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-766-1163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty